LX SAMPLE FORM ONLY Project ID:

Transcription

LX SAMPLE FORM ONLY Project ID:
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AUSTRALIAN RESEARCH COUNCIL
LINKAGE INTERNATIONAL
APPLICATION FORM FOR PROPOSALS FOR FUNDING
COMMENCING IN 2008
Awards
LX
Note: you must read the ‘Linkage International Funding Rules for Proposals for funding commencing in 2008’ and the relevant ‘Linkage
International Instructions to Applicants for Proposals for funding commencing in 2008’ before filling out this form.
Project ID:
Total number of sheets contained in this application
Information on this form and its attachments is collected in order to make recommendations to the Minister on the allocation of financial
assistance under the Australian Research Council Act 2001 and for post award reporting. The information collected may be passed to
third parties for assessment purposes. It may also be passed to the National Health and Medical Research Council, the Department of
Foreign Affairs and Trade, the Department of Industry, Tourism and Resources, the Department of the Environment and Heritage, the
Department of Education, Science and Training, the Department of Agriculture, Fisheries and Forestry and the Department of Veterans’
Affairs for the purpose of checking eligibility. In other instances, information in this Proposal can be disclosed without your consent where
authorised or required by law.
PART A—ADMINISTRATIVE SUMMARY
A1
ORGANISATION TO ADMINISTER FUNDING
(Please note this question must be completed first)
Name
A2
PROPOSAL TITLE
(Provide a short descriptive title of no more than 20 words. Avoid the use of acronyms, quotation marks and
upper case characters.)
A3
PARTICIPANT SUMMARY
A3.1 Participant Details - Current Organisations
(Enter details of the lead Chief Investigator at Person number 1)
Chief Investigator (CI), Overseas Investigator (OI), and Partner Investigator (PI)
Person
Family name
Initials
Current Organisation
number
1
2
3
4
5
Role
A3.2 Participant Summary - Organisations applicable to this Proposal
(This table is ‘read only’ and provides a Summary of Organisational Affiliations for participants. This table will
populate once B8.2 is completed for each participant.)
Person
Number
1
2
3
Family Name
Initials
Current Organisation
Relevant Organisation for
this Proposal
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Role
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A4
REQUESTED SUPPORT
A4.1 This Proposal requests funding for the following scheme category:
Linkage International Awards
A4.2 Years for which support is being sought from the ARC
Year 1
Year 2
Year 3
A4.3 ARC Projects funded for 2007 that include this Proposal's first-named CI
(This question is mandatory - please refer to Linkage International Funding Rules subsection 12.1.3.2)
Scheme
A5
Project
ID
st
Project's 1 named CI
Project Title
Approved
years of
funding
(incl. 2007)
SUMMARY DESCRIPTIONS
A5.1 Summary of Proposal
In no more than 100 words (approx. 750 characters) of plain language, summarise aims, significance and
expected outcomes of the collaborative research.
A5.2 Summary of Collaboration
In no more than 100 words (approx. 750 characters) of plain language, summarise the proposed collaboration.
A5.3 Summary of National/Community Benefit (for Public Release)
In no more than 100 words (approx. 750 characters) of plain language, summarise the national/community
benefits that are expected to arise from the collaborative research.
A6
CLASSIFICATIONS AND OTHER STATISTICAL INFORMATION
A6.1 National Research Priorities. If relevant, click the ‘National Research Priorities’ button to select one or
more relevant Priority Goals for a designated National Research Priority.
National Research Priority
Priority Goal(s)
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A6.2 Keywords
A6.3 Research classifications (list from highest to lowest %, to the nearest multiple of 10%)
Research Fields, Courses and
Disciplines (RFCD)
%
Socio-Economic Objective
(SEO)
%
A6.4 Country/ies of international collaboration
A7
ADDITIONAL DETAILS
A7.1 Have you submitted or do you intend to submit a similar Proposal to any other agency?
Yes
No
If yes, please select one of the following:
If other is selected above, please enter the full name of the agency:
A7.2 Has a successful eligibility exemption/ruling been granted by the ARC relating to this Proposal?
Yes
No
a) If Yes, please indicate the type of eligibility exemption/ruling granted and enter the 10-digit
identifying number for the exemption/ruling provided by the ARC:
Eligibility Ruling type:
Successful exemption number(s)
(Eg. LXEC08----):
Medical and Dental Research
Overseas Organisation
Other
If Other, please specify the type(s) of eligibility ruling granted:
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A7.3 Does the Administering Organisation have arrangements to manage intellectual property and facilitate
commercialisation of research?
Yes
No
If Yes, in no more than 100 words (750 characters) of plain language, summarise these arrangements.
A8
RESEARCH STUDENTS
The ARC is interested in reporting the number of Research Students that would be involved in this Proposal if
it is funded. Please enter the number of students places (full-time equivalent) that will be filled as a result of
this project. (Round FTE to 1 decimal place)
Australia
Overseas
PhD
Masters
Honours
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A9 CERTIFICATION
The Administering Organisation must obtain the required agreement and hand-written signature(s) of all
parties necessary to allow the proposed research to proceed.
Certification by the Deputy/Pro Vice-Chancellor (Research) or their delegate or equivalent in the
Administering Organisation
I certify that—
•
I have obtained the written agreement of all parties identified in the Proposal to submit this Proposal.
•
Proper enquiries have been made and I am satisfied that the participants listed in Part A3 meet the
requirements specified in the ‘Linkage International Funding Rules for funding commencing in 2008’.
•
The Head of Department has approved this Proposal.
•
This organisation supports this Proposal and if successful will provide basic facilities and the items listed in
the budget for the project.
•
I have obtained the written agreement of the other organisation(s), if any, involved in this Proposal to
contribute the resources outlined in this Proposal.
•
I have obtained the written agreement from the relevant employer(s) for the participation, to the extent
indicated in this Proposal, of the participants listed in Part A3.
•
I am prepared to have the project carried out in my organisation under the circumstances set out in this
Proposal and in accordance with the ‘Linkage International Funding Rules for funding commencing in
2008’.
•
The amount of time that the researcher(s) will be devoting to the project is appropriate to existing
workloads.
•
The project can be accommodated within the general facilities in this organisation, and if applicable, within
the facilities of other relevant organisations specified in this Proposal, and sufficient working and office
space is available for any proposed additional staff.
•
All funds for this project will only be spent for the purpose for which they are provided.
•
The project will not be permitted to proceed until appropriate ethical clearance(s) has been obtained.
•
I will notify the ARC if there are changes to named participant(s) listed in Part A3 after the submission of
this Proposal.
•
To the best of my knowledge, all conflicts of interest relating to parties involved in or associated with this
proposal which arise after the submission of this Proposal.
•
I consent, on behalf of all the parties, to the ARC copying, modifying and otherwise dealing with
information contained in this Proposal for any of the purposes specified in subsection 11.4.2 of the
‘Linkage International Funding Rules for funding commencing in 2008’.
•
I consent, on behalf of all the parties, to this Proposal being referred to third parties, who will remain
anonymous, for assessment purposes.
•
To the best of my knowledge, the Privacy Notice appearing at the top of this application form has been
drawn to the attention of all the participant(s) whose personal details have been provided at Part B.
•
To the best of my knowledge all details provided in this application form and in any supporting
documentation are true and complete and no information specifically relating to personnel track or
publication records is false or misleading.
•
I understand that it is an offence under the Criminal Code Act 1995 to provide false or misleading
information.
•
I understand and agree that all statutory requirements must be met before the proposed research can
commence.
Signature of DVC/PVC(R), delegate or equivalent
(in black ink)
Name and Position
(please print)
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Date
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PART B—PERSONNEL
B1
PERSON NUMBER
B2
CURRENT DETAILS
GAMS ID
Family name
Role
First name
Second name
Title
Current Department/school/other
Current Organisation
B3
POSTAL ADDRESS
Department/school/other
Organisation
Postal address line 1
Postal address line 2
Locality
B4
State
Postcode
Country
MEMBERSHIPS/ASSOCIATIONS
B4.1 Are you a current member of the ARC or its advisory committees?
Yes
No
B4.2 Are any of your relatives or close social/professional associates members
of the ARC or its advisory committees?
Yes
No
If Yes, please name the ARC member(s)
B5
HAVE YOU EVER BEEN AWARDED A FELLOWSHIP FROM THE ARC?
Yes
No
Please indicate if you have received any of the following Fellowships from the ARC: APD, APDC, APDI, ARF,
QEII, SRF, APF, RC-ATSI, IRF or ARCIF.
Project ID
Year funding
Year funding
Fellowship type(s)
commenced
concluded
(or expected to
conclude)
B6
AFFILIATIONS
If you are nominated as a Chief Investigator, will you be receiving salary in 2008 from an organisation which is
outside the higher education sector and which is funded predominantly from State/Territory or Commonwealth
Government sources and such funding is provided mainly for research activities?
Yes
No
If yes, describe the nature of your employment, association, and/or financial interest (including specifying the
% of salary):
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B7
QUALIFICATIONS
B7.1 PhD qualification awarded
Discipline/Field
Organisation
Country
Month and Year awarded
(mm/yyyy)
(or) Date Thesis Submitted/
Proposed Submission Date
B7.2 Other qualifications (including highest Qualification if not PhD)
Degree/Award
B8
Year
Discipline/Field
Organisation and Country
ACADEMIC, RESEARCH, PROFESSIONAL AND INDUSTRIAL EXPERIENCE
B8.1 Current and previous appointment(s)/position(s) - during the past 10 years
Position held
B8.2
Organisation
Department
Duration and
Status
Organisational affiliations for eligibility purposes of this Proposal
Name of the organisation you will be associated with for the purposes of satisfying the eligibility
requirements for your nominated role in undertaking the proposed research collaboration (see
Sections 5 and 12 of the ‘Linkage International Funding Rules for funding commencing in 2008’)
Role
CI, OI, PI
Organisation
Type of Affiliation
[Select Organisation for CIs. For OIs or PIs
select relevant organisation or ‘Other’ and
type the name of the relevant organisation]
[Select from Employee, Adjunct
Appointment, Federation Fellow, Other]
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This page serves as a check list for PART B9
Once the Application Form has been printed, replace this page
with the following pages:
B9 CURRICULUM VITAE
Attach to the Application Form a curriculum vitae of one page for each named participant at A3, including the
following details:
• name
• a list of the ten most significant relevant publications for the last five years
• the total number of peer-reviewed research publications over the last five years
• any other relevant details not included elsewhere within the Application Form
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PART C—PROJECT COST
Costs should be quoted exclusive of the GST.
C1
BUDGET DETAILS
C1.1 Year
COSTING
Column 1
Source of funds
2
ARC
3
Administering
Organisation
COSTS
Travel - Airfares
Total Airfares (a)
Travel - Other (Local & Subsistence)
Total Other Travel (b)
Consumables (up to $5,000)
Total Consumables (c)
Other
Total Other (d)
TOTAL COSTS (e)
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4
Other
5
Total
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This page serves as a check list for PART C2, C3 and C4
Once the Application Form has been printed, replace this page
with the following pages:
C2
JUSTIFICATION OF FUNDING REQUESTED FROM THE ARC
In no more than one A4 page fully justify in terms of need and cost, each budget item requested from the
ARC (Column 2 in Section C1), including value for money. Use the same headings as in Column 1 of Section
C1.
C3
DETAILS OF NON-ARC CONTRIBUTIONS
In no more than one A4 page provide on explanation of how non-ARC contributions (Columns 3 and 4 in
Section C1) will support the Proposal (use the same headings as in Column 1 of Section C1). Contributions
from Partner Investigators must be highlighted.
C4
LETTERS OF SUPPORT
A letter of support must be attached from any Organisation other than the Administering Organisation
indicating financial commitment to the proposed collaborative research project.
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PART D—RESEARCH SUPPORT
D1
RESEARCH SUPPORT OF ALL PARTICIPANTS
For each participant listed in Part A3, provide details of research funding for the years specified in the
table below. That is, list all projects/proposals/fellowships awarded and any requests submitted
involving that participant for funding.
•
The current Proposal is listed first and will be auto populated into the table. List other Proposals and/or
projects (including fellowships) in descending date order.
•
ARC-funded projects/fellowships for which reports (including Progress and Final Reports) required in the
Conditions of Grant/Funding Contract/Funding Agreement have been submitted should be indicated by a
double asterisk (**) after the Description.
•
Asterisk (*) refers to any items that are in the same area of research as this Proposal.
•
Support types (Sup type) are ‘R’ for requested support, ‘C’ for current support, ‘P’ for past support.
•
The ARC Project ID applies only to Proposals, current and past projects (including fellowships), funded by
the ARC.
Note, details should be provided for all sources of funding, not just ARC funding. Show all amounts in
Australian dollars.
Description
(All named investigators on any
Proposal or grant on which a
participant is involved, project
title, source of support, scheme)
(*)
Sup
type
ARC
Project ID
2006
($’000)
2007
($’000)
2008
($’000)
(if applicable)
Current
proposal
begins
in 2008
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2009
($’000)
2010
($’000)
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This page serves as a check list for PART D2
Once the Application Form has been printed, replace this page
with the following page(s) (where appropriate):
D2
STATEMENTS ON PROGRESS OF ARC-FUNDED PROJECTS
For each participant listed Part A3, include with the Proposal a statement detailing progress for each
project/fellowship involving that participant which has been awarded funding for 2006 under any ARC scheme.
D2.1 List of the projects that you are providing statements for:
E.g.
Scheme
Project ID
First named
investigator
Project Title
D2.2 Provide the statements
Write no more than one A4 page for each funded project.
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This page serves as a check list for PART E
Once the Application Form has been printed, replace this page
with the following:
PART E - PROPOSAL DESCRIPTION
E1
ADDITIONAL TEXT
Additional text must be provided addressing the selection criteria at the relevant Section of the 'Linkage
International Funding Rules for funding commencing in 2008' within the format specified in the Funding Rules.
Linkage International Awards
In no more than three A4 pages, consider the selection criteria and provide the following information:
E1.1
a brief outline of the aims, significance, background and expected results for the proposed
collaborative research project;
E1.2
a brief description of the nature, strengths and benefits of the collaboration including the role of, and
benefit to, the Australia-based and overseas parties; and
E1.3
a management plan for the collaboration, including a proposed schedule of visits. Please present this
plan as a table with the following information for each visit: dates, name and status of researcher(s)
travelling, destination, activity to be performed and funding source.
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